| [Objective]To form a cognitive reappraisal intervention program on ruminative thought in breast cancer patients with postoperative chemotherapy,and evaluate its clinical application effect,so as to provide reference for emotional symptom management of breast cancer patients.[Methods]1.Through literature research,a draft of cognitive reappraisal intervention program on ruminative thought in breast cancer patients with postoperative chemotherapy was initially developed.Carried out expert consultation,revised and refined the intervention draft according to expert opinions,formed a formal intervention program.2.From June 2022 to November 2022,breast cancer patients in postoperative chemotherapy period who met the acceptance criteria were continuously included in the breast surgery department of two Class A tertiary hospitals in Suzhou.The patients were divided into control group and cognitive reappraisal group by random number table.During the hospitalization of the control group,nursing staff provided nursing,health education,and rehabilitation guidance in accordance with the routine nursing care of breast surgery specialists.At the 4 intervention time point,they entered the pre arranged activity room and received one-on-one routine psychological care from the department;After discharge,the patient underwent routine telephone follow-up;The intervention duration was 4 chemotherapy cycles.On the basis of the control group,patients in the cognitive reappraisal group entered the activity room at the same intervention time point to receive one-on-one cognitive reappraisal intervention program on ruminative thought,including four thematic interventions:mutual familiarity,cognitive reappraisal symptom rumination intervention,cognitive reappraisal compulsive meditation intervention,and cognitive reappraisal reflection contemplation intervention.The Ruminative Responses Scale(RRS)and Self-rating Depression Scale(SDS)were used to collect relevant data on ruminative thought levels and depressive emotions of two groups of patients before the first intervention(T1)and after the second,third,and fourth intervention(T2,T3,T4).SPSS 23.0 statistical software was used for data analysis.Two factor repeated measurement analysis of variance was used to evaluate the intra group and inter group differences in ruminative thought and total depression scores between the two groups of patients at different time points(T1,T2,T3,T4).Paired sample t-tests were used to compare the mean values of ruminative thought dimensions before and after the intra group intervention(T1,T4),Two independent sample t-tests were used to compare the mean values between the two groups in various dimensions of ruminative thought before and after intervention(T1,T4).[Results]1.The preliminary draft of cognitive reappraisal intervention program on ruminative thought in breast cancer patients with postoperative chemotherapy based on literature research includes intervention topics,intervention methods,intervention content,and evaluation indicators.The draft has been further revised and improved through expert consultation,resulting in the formation of a cognitive reappraisal intervention program on ruminative thought.2.A total of 77 patients with breast cancer in the postoperative chemotherapy period were included.The patients were randomly divided into a control group and a cognitive reappraisal group.There were 38 cases in the control group,39 cases in the cognitive reappraisal group.During the study,4 patients in the control group withdrew,5 patients in the cognitive reappraisal group withdrew,and 34 patients in both the final control group and the cognitive reappraisal group.Before intervention,there was no statistically significant difference between the control group and the cognitive reappraisal group in the scores and total scores of general information,ruminative thought,and depression(P>0.05).3.The score of ruminative thought after intervention:① Analysis of variance for repeated measurements of two factors at each time point in the two groups:The results of the main effect of time within the two groups,the main effect of intervention between the two groups,and the interaction effect between intervention and time were statistically significant(P<0.05);The results of simple effect analysis showed that the simple effect of time in the control group was not significant(P>0.05),while the simple effect of time in the cognitive reappraisal group was significant(P<0.05);The paired comparison results showed that there was no statistically significant difference between the four time points in the control group(P>0.05).The total score of T4 ruminating thinking in the cognitive reappraisal group was lower than T1,T2,and T3,with significant differences(P<0.05),while there was no statistically significant difference between T1,T2,and T3(P>0.05);Compared with the control group,the simple effects of T1,T2,and T3 interventions in the cognitive reappraisal group were not significant(P>0.05),and the total score of ruminative thought at T4 was lower than that in the control group,with significant simple effects of intervention(P<0.05)Intragroup comparison before and after intervention(T1,T4):There was no statistically significant difference between the ruminative thought score(T4)of the control group and the baseline level(T1)(P>0.05);After intervention(T4),the scores of symptoms,rumination dimension,forced meditation dimension,and total ruminative thought in the cognitive reappraisal group were lower than those before intervention(T1),with a statistically significant difference(P<0.05).The scores of reflective reflection dimension(T4)were lower than those before intervention(T1),with no statistically significant difference(P>0.05)Comparison between groups after intervention(T4):The scores of each dimension and total score of ruminative thought in the cognitive reappraisal group were lower than those in the control group,with a statistically significant difference(P<0.05).4.Depression score after intervention:Analysis of variance for repeated measurements of two factors at each time point in the two groups:The results of the main effect of time within the two groups,the main effect of intervention between the two groups,and the interaction effect between intervention and time were statistically significant(P<0.05);The results of simple effect analysis showed that the simple effect of time in the control group was not significant(P>0.05),while the simple effect of time in the cognitive reappraisal group was significant(P<0.05);The paired comparison results showed that there was no statistically significant difference between the four time points in the control group(P>0.05).The total depression score of T4 in the cognitive reappraisal group was lower than that of T1,T2,and T3,with significant differences(P<0.05),while there was no statistically significant difference between T1,T2,and T3(P>0.05);Compared with the control group,the simple effect of intervention in the cognitive reappraisal group was not significant at T1 and T2(P>0.05),and the total score of depression at T3 and T4 was lower than that in the control group.The simple effect of intervention was significant(P>0.05).5.In the cognitive reappraisal group,breast cancer patients with postoperative chemotherapy given a high unit evaluation and overall evaluation of the cognitive reappraisal intervention program on ruminative thought.During the implementation of the cognitive reappraisal intervention program on ruminative thought,no adverse events were reported.[Conclusion]1.The cognitive reappraisal intervention program on ruminative thought can effectively reduce the ruminative thought level of breast cancer in the postoperative chemotherapy period,and help patients reduce ruminative thought.2.The cognitive reappraisal intervention program on ruminative thought can effectively alleviate the depression of breast cancer in the postoperative chemotherapy period,and improve the psychological status of patients.3.The cognitive reappraisal intervention program on ruminative thought formed by this research has applicability and feasibility in the management of ruminative thought and depression of breast cancer patients in postoperative chemotherapy period,and can be popularized in postoperative chemotherapy period breast cancer patients. |
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